An on-line friend, colleague and outspoken patient advocate, Trisha Torrey, has an ongoing e-vote about whether people prefer to be called a “patient” a “consumer” a “customer” or some other noun to describe a person who receives health care.

My vote is: PATIENT.

Here’s why:

Providing medical care is or should be unlike other commercial transactions. The doctor, or other person who gives medical treatment, has a special professional and moral obligation to help the person who’s receiving his or her treatment. This responsibility – to heal, honestly and to the best of one’s ability – overrides any other commitments, or conflicts, between the two.

The term “patient” constantly reminds the doctor of the specialness of the relationship. If a person with illness or medical need became a consumer like any other, the relationship – and the doctor’s obligation – would be lessened.

Some might argue that the term “patient” somehow demeans the health care receiver. But I don’t agree: From the practicing physician’s perspective, it’s a privilege to have someone trust you with their health, especially if they’re seriously ill. In this context, the term “patient” can reflect a physician’s respect for the person’s integrity, humanity and needs.

9 Comments

Elaine,
Great post and I couldn’t agree with you more. I like calling myself a patient for the exact reasons you mentioned–I like being under the care of someone I trust. I did a blog called I’m a patient, not a consumer for Kevin MD and got 80 comments (compared to the 2 or 3 I usually get.)

Marc,
You may be right. I’d had “his or her” in the draft, then thought it seemed too wordy. Some writers do use “their” for singular possessives in this kind of situation. I agree the usage isn’t optimal.

As for sexism, I hope there is none here. What’s relevant is the issue of paternalism, which may linger after years in practice and, maybe, my persistent (and un-PC) ambivalence about its value in medicine.

A person seeking medical treament should feel comfotable asking questions and voicing concerns. (Scratch the term “empowered” from my lexican). Using an alternative term is not a gurantee for accountability, responsible cost containment, and improved outcomes, but rather an Orwellian obfuscation.

I’m actually not hung up on the term patient or consumer, but tend to be rather more focused on practical issues… like does my doctor email, will they have inclusive discussions about the issues at hand and able to discuss options so I feel involved in the decision rather than have some solution just dumped on me like court decision.

All too often these days, doctors are still in the old fashioned and arrogant patriarchal mode of ‘nanny (or doctor) knows best.’

Thanks, all, for your thoughts on this. You may be right, Nora, if what you’re saying is that the “empowered” term makes people feel in control when they’re not, and that the term is no guarantee for anything. Sally, your focus on the practical aspects of the exchange – accessibility, (patient’s) inclusiveness in discussions, etc. – rather than on the terminology, seems sensible.

Still, as a doctor, I think language forms how we think about the relationship.

The National Health Council provides a united voice for the more than 130 million people with chronic diseases and disabilities and their family caregivers. In our presentations and writings, we make a distinction between patients and consumers: A consumer is someone who goes in and out of the health care system as needed. A patient is someone who is dependent on the health care system in order to live a better, more healthy life.

Nancy Hughes
Assistant Vice President
Communications and Marketing
National Health Council

Well put! It is a privilege to treat patients, and this is accompanied by a duty to the patient commensurate with this trust. I can’t help but wonder, though, what your opinion is of physicians who offer specials to ?patients via Groupon, as has been done.